Interrupting people in 1:1 conversation (mostly my GP)

[JFT]

Help me out here please!

OK firstly I'm ASD and struggle with some things when it comes to social communication - because I'm direct, open, straight to the point (not brutal, not insensitive, not rude) - and I cannot for the life of me 'read between the lines' or comprehend socially polite phrases that mean something different than the words. This causes a few minor issues not much. I get on well with people and my friends say I'm a good listener.

My situation is this - at the moment I'm under many many healthcare appointments as I'm awaiting major surgery. I also have some other M/H issues that I'm in treatment assessment for (relating to PTSD). This is all driving me nuts as it's my vast observation that healthcare workers (not all, but many) like to tell you what's what before having even debriefed you or heard you out. So they'll go on some upcoming big explanation of a thing that's possibly a) not relevant to my situation in any way; b) explaining in detail things I already know in detail; c) has already been way overshot by new developments / test results, new information etc; d) involves trying to book me in for something that's already been done and established; OK, all totally understandable, it happens.

BUT the issue is, my idea of being helpful and normal is to interrupt the person at the beginning and say 'just to let you know that's already been done' or whatever. I'm trying to be proficient and not have to endure an entire dialogue that is a total waste of time and them waste their breath too.

Same as if I met you in the street and you told me you were on your way to Argos to buy eight things and then you started describing them to me but I already know Argos is closed for two weeks. Am I going to say right at the beginning hey, sorry to interrupt but Argos is actually closed for two weeks? Well that's what I do. Usually in friends conversations they don't mind an interruption of that sort. I'm finding with healthcare professionals - nurses and GPs especially they cannot tolerate this interruption. Then they get angry with me and say things like 'can I speak please' or 'can you not interrupt me' or 'let me finish what I'm saying'. This is a repeat scenario and I'm struggling with it, they get really really annoyed and bordering angry - even I think they have me as a 'difficult / challenging patient'.

Say for example GP says 'OK I'm going to send you for a blood test to check your ferritin levels (and I literally just had that done on my way in the surgery) and then they bang on about a long winded conversation of what ferritin level means (and I am literally my own expert on managing my iron deficiency) and then they even start telling me which direction to find the blood unit (I know I've been there a thousand times, I was just there) and how long it will take for the results to come back (I know, I've had a thousand blood tests) and what the treatment will be if my readings are low and on and on and on (I know, I've been having iron treatment for a decade)... my version of not having to have that whole conversation is to INTERRUPT right at the beginning so as to save us all a whole load of time and effort and also assure I am aware. But this is causing me problems.

Is it me? I am suppose to let a person finish a whole long winded thing of unnecessary info before declaring that I already did that / already know that / this is not addressing the issue at hand?

What is the best way of dealing with these type of things?

If I didn't interrupt / dispute some of the stuff that's being said or done I'd be in a right pickle as I've been in a huge system fail with the NHS already so I haven't to try and keep on top of it all and not allow a healthcare worker to misdirect me - also this is a big part of the 'interrupting' as often the person is misdirecting me so I'm not just going to 'go along' with it or I'd probably be dead by now.

I think you are quite correct to be upfront, saves wasting everyone’s time and effort.
Regarding GPs/HCPs there are some great ones who are skilled and experienced in consultation, use validated models and actively listen to understand and work with a patient to provide effective and collaborative care. There are others who don’t seem to know know how to consult properly, work to their own agenda and have a superior attitude which helps no one. I am glad you challenge this and
I admire your forthright approach.

YANBU but you might be breaking social convention. The polite thing to do would be to hear them out then to tell them the information that’s relevant. However as a ND person it can be very painful to have to sit through pointless inefficient rubbish. Do you want to be their friends? Do you care if they like you? If not continue to make sure your care is accurate and informed. Or like most of us find an uneasy middle ground of trying to let them say their thing without being too pushy but also getting your point across.

I agree with you. If you’re being sent for a test you’ve just had, you should be able to tell them!

I think they sometimes have a mental script that they reel off, and they don’t change it to suit the patient in front of them. They don’t want to get into a Q&A with a patient who is seeing all this for the first time, so to avoid the questions they believe the patient will ask, they give them all the directions etc. in a monologue. Which is unhelpful for a lot of patients who do know where to go, what the tests are etc. And some doctors find it impossible to believe (or remember) that some patients really do have a good understanding of their condition.

My GP is awful for this. On the rare occasions that I get an appointment (always a phone one now), she asks me yes/no questions then gabbles away, not letting me speak.

I have ADHD and I'm a terrible interrupter but rarely do I annoy people with it. I think you have to find a break point like where they've paused for breath, and do it in a tone of voice/try and arrange your face into an expression that shows them that you are trying to be helpful rather than being annoyed with them for not knowing the background (which is definitely annoying but you don't have to let them see that).

Another thing I've learned by observing other people is, sometimes for social cohesion it's best to let people tell you things you already know.

It also helps if you use your body language to show them you've got something to say before you jump in. This is definitely one to practice. Even just raising your hand a little bit with an apologetic smile can give them a signal that you have something important to say. It's not an exact science though and you might want to try some stuff.

Remember, different NT people react differently to the same input, as well, so what annoys one person won't necessarily bother another.

I think you might be right, I'm breaking a convention maybe?

With friends I can usually hear them out with stuff even if it's 'on repeat' as I don't mind, it's not affecting me.

It's definitely with the healthcare professionals (genuinely no offence to healthcare professionals here) it's getting unmanageable as to the level of anger they elevate to. And obviously I don't want to alienate them as I need them for my health.

Today my (not usual) GP got super irritated with me but she was banging on about making me referrals to systems I've already been through. So I kept trying to interrupt her to say so and what the outcome was. If she made those referrals they'd be rejected. Anyway she got angry and said 'stop interrupting me' in a way that was very hostile. Even so, she made a referral to a process I've already just been through. It will probably be rejected.

Also I could tell by the end of the conversation she was very very fed up, didn't GAF, and has no intention of ever speaking to me again or offering a follow up (she didn't offer a follow up). So, my interrupting has not served me well as it has induced a short-tempered, hostile, irritated reaction from someone who started out 'neutral' but probably now hopes to never speak to me again, never mind is going to be a helpful actor in my situation. I made her day worse. Oh dear.

I'm neurotypical but find i have the same issue as you whenever i have had to use the NHS and the consultants attitude of 'i will complete what I'm saying even if I have information incorrect or missing!' so infuriating. I'm trying not to waste their time as much as i'm ensuring they aren't wasting mine!

I’m neurotypical and agree with you. “I’m so sorry to interrupt - I really appreciate all this but….”.

otherwise the world is just tortuous!

you sound very thoughtful

They probably want to write that they've said or done certain things in their notes! I think you should get cross back and politely point out that they aren't acting in a patient centred manner by not listening to you properly.

Try smiling and saying “um, sorry” before you interrupt. Also try not to interrupt too many times. Once you have interrupted the first time if they say something else you disagree with try frowning or shaking your head slightly (the way you would to say no) but not interrupting.

I agree with you so long as its done politely and isn't taken too far. Just be careful you aren't incorrectly assuming you know what they're going to say though!

For example using your ferritin scenario, lets say the Dr was about to tell you that they want to test your ferritin because although it was measured pre-surgery last week it may be low now as a result of the surgery. It might then be annoying if you jump in before they've barely said anything to correct them and let them know you had ferritin tested so don't need it done again.

In that case it would make a difference how you interrupted. "Can I just quickly mention before you go any further that I had ferritin checked pre-surgery last week, I don't know if that changes anything" would be fine. Something very blunt and non-apologetic (given you're interrupting) would be less so.

Some people are just impatent and grumpy due to who-knows-what, so if you feel you got it right it may just be one of those things where you can't win and is best forgotten about.

I think most people are able to do this without causing offence. Do you do it repeatedly, or in a loud voice? Do you make eye contact first and indicate that you'd like to speak?

I think, on consideration of various inputs from people here, there's two key aspects:

1. It's definitely a certain type of person I'm rubbing up the wrong way / they're rubbing me up the wrong way! Dogmatic people who are reeling off something they've decided to say regardless of whether it's truly pertinent or relevant. Also in that same category, people who are trying to find a very quick response to close down the situation, having not heard me out, which could be called 'fobbing off' but they perceive is 'solving the problem'. I feel repeatedly shut down and fobbed off and not listened to by these type of people. I wouldn't normally encounter that type of person so for me, it's within the healthcare sector. I guess they might also be in other jobs like 'customer complaints' or such.

2. Due to feeling fobbed off and the attached trauma, I guess I get a bit too hasty and too repetitive with my interruptions - because I literally can't stand it. I can't stand it like if you were pouring boiling water on my foot (due to ASD / impatience / despair at being fobbed off) so I'm responding with that sort of urgency like the inference is coming off too urgent. So then I'm also probably doing too many interruptions with a declining level of 'erm, can I just say...' or 'sorry to interrupt but...' introductions and more like just going straight into something like 'I spoke to them on Friday'. At this point the person is like wow can I say even one whole sentence.

My secret thought is if every sentence you're going to start is a step in the wrong direction then actually no I'd rather you didn't complete your whole sentence. However, I know that's 'wrong' and it's me and my problem that I've got to learn better. On the upside there's no emotion connected to this, for example I don't feel hateful or angry or distainful of the person, I can see where it's all going wrong. But they probably don't know that and think I'm being hateful to them to boot or that I totally disrespect them on. Have work to do!!

You may already do this, but I (NT person) think in some of these situations, I would be making a "oh I've got something relevant to contribute" face (eyebrows up, like the 🤔 emoji but less grumpy looking) and waiting for them to pause, or to ask "yes?" - and then sharing my relevant information. Interrupting in the sense of literally starting talking when someone is talking can feel quite aggressive to NT people - but interrupting as in making a non-verbal signal you want to pause things and add information is much less likely to be interpreted that way, if used sparingly.

To satisfy their duty of care, health professionals have to tell you certain things. Dangerous to rely on a patient saying "I already know that" as you may have received erroneous info or may have incorrectly understood what you are being told.

Let them do their job properly and listen to their advice / recommendations.

Really not that painful to wait until they have finished?

*Also, in person, it's far better than over the phone - phone is worst.

** Also, with other people present it's far better as the person in question usually begins to at least listen to me / my question / my point, whereas 1:1 they're more like 'let me speak over you to no good end and then get you quickly back out that door'.

For example, I had questions for my genito-urinary surgeon (mostly as I had no idea I was having genito-urinary surgery as part of my big surgery). Met her for two minutes (pre-booked hospital appointment), she 'delivered' me a tiny speech about ureter stents and when I tried to ask a question she leapt up, went in the next room, fetched three nurses to whizz me off on the grounds that I 'needed my blood pressure checked'. Well obv nobody needs their blood pressure checked that urgently and it was just a way to scoot me off and close the door on me. So, I 'interrupted' because I had a question and she was not at all receptive to this and angrily dismissed my question and still scooted me out the door. I suppose it's quite funny on analysis.

I am like this too. I feel rather than them go on about something and waste time I have to tell them (extremely politely) that I have already explored this or that. I don’t want to come across as a knowitall but I find myself being rude but I can’t help myself as I really feel it would save both of our times and they would actually listen to me properly. I am on asd pathway after my dc got diagnosed but loooong wait.

Yes the phone is the worst 😂

I think it's fine to interrupt, 'sorry but I had that test last week'.

In this regard I'm going to try much much harder to be patient. It's on me!

I think it's my increasing frustration with GP and going through repeat loops of fobbing off - but it's like I can't quit asking as the issues are serious and urgent, profoundly negatively affecting my whole life. And they can't / won't progress anything for whatever reason. So I'm stuck in redundant repeat loops like going round a spirograph circle when I'm trying to get off the circle and over there.

I'm kind of aware it's their aim to say blah blah blah and then bye and they've got me off the phone. Well then it's another two three weeks before I can get an appointment. So, I interrupt and it goes all wrong anyway.

I think healthcare professionals want to cover themselves so even if you've heard it before, they themselves need to tell you.

Otherwise you get people who say 'well you didn't tell me that!' and they'll end up in trouble.

I think interrupting to tell them you've already had a test done is fine though.

I'm finding with healthcare professionals - nurses and GPs especially they cannot tolerate this interruption. Then they get angry with me and say things like 'can I speak please' or 'can you not interrupt me' or 'let me finish what I'm saying'. This is a repeat scenario and I'm struggling with it, they get really really annoyed and bordering angry - even I think they have me as a 'difficult / challenging patient'

I think the fact that this is happening repeatedly, and they are genuinely showing signs of annoyance, then it's probably not the fact that you're interrupting, but the way you're doing it. The tone you use and the point at which you choose to interrupt might be the issue here, maybe? Perhaps you do it in a way that sounds snappy, or perhaps you interrupt before they've had a chance to fully explain - for example:

GP: "OK, I think we need to refer you for a scan because you're - "
PATIENT: "Can I stop you there? I've already had a scan."

The above interruption could potentially be very rude and annoying, because the GP hasn't even got far enough to explain why they want you to have the scan. For all the patient knows, the GP might be about to suggest a different kind of scan or a repeat scan to double-check or something, so the patient is jumping the gun and being dismissive by immediately jumping in. For example, a more productive and polite way to have that conversation would be:

GP: "OK, I think we need to refer you for a scan because you're definitely showing possible symptoms of an ovarian cyst."
PATIENT: "Sorry to interrupt - I did have a scan last month to check for cysts and they didn't find anything. Does that mean there's a chance they could have missed something?"
GP: "Possibly - I want you have to have this second scan just in case, yes - cysts can grow quickly or be harder to spot at certain times of your cycle" OR "Ah, I see - sorry, I didn't see that in your notes. In that case, we'll go on to the next step and refer you to a specialist."

Exactly this. I deal with medical complaints and if a healthcare professional hasn't explained certain things or said certain things and recorded it they will be criticised and may in certain circumstances end up in serious trouble.

You don't always know that everything they say is going to be irrelevant to you until it's said. Also often hcp have a certain script they follow to ensure all the relevant information is covered. Again I had a situation where the hcp was interrupted by the patient as they were 'winding up' the appointment and they ended up on a tangent and the hcp then missed out a bit of very important information which did have serious consequences for everyone involved. The interruption was not important and could have waited until the hcp had stopped speaking.

Oh, and having seen your follow-up posts now - I think that if people are taking issue with you interrupting, then it might helpful for the doctor-patient relationship if, when they say 'Please don't interrupt me', you say something like 'Sorry, I didn't mean to be rude - I'm on the autism spectrum and I can't always judge the right time to speak, sorry if it came across badly'.

I'd say "Can I just stop you there?" and then say my bit, whether they want to hear it or not.

It sounds like they are not good communicators and want to just reel off a script.

I agree with all this and thank you for your input and I'm going to re-read this whole thread later with lots of considerations.

I would say, sadly, the situation has not yet been revealed where they were going to say / do something constructive or moving the situation forwards that I had misunderstood.

It's more like a stance of perpetually disputing anything I say by making a small speech about something slightly off topic and then 'by then off you pop'.